Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.45 / $110.00 / $129.60	Facility	26	$72.45	$110.00	$129.60
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $64.47 / $122.14 / $388.96	Facility	53	$64.47	$122.14	$388.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $250.00 / $475.00 / $600.00	Professional		$250.00	$475.00	$600.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.13 / $110.00 / $146.32	Professional	26	$67.13	$110.00	$146.32
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $85.26 / $275.00 / $300.00	Professional	52	$85.26	$275.00	$300.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $172.50 / $335.00 / $440.00	Professional	TC	$172.50	$335.00	$440.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $129.78 / $176.40 / $220.50	Professional		$129.78	$176.40	$220.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $64.22 / $73.17 / $89.75	Professional	26	$64.22	$73.17	$89.75
BCBS Facility/Professional Professional Modifier Low / Median / High Price $267.81 / $337.82 / $449.76	Professional		$267.81	$337.82	$449.76
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $82.24 / $113.82 / $138.22	Professional	26	$82.24	$113.82	$138.22
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $185.57 / $232.98 / $310.13	Professional	TC	$185.57	$232.98	$310.13
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $63.57 / $67.01 / $106.75	Professional	26	$63.57	$67.01	$106.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.48 / $244.21 / $608.04	Professional		$123.48	$244.21	$608.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.64 / $82.65 / $142.72	Professional	26	$45.64	$82.65	$142.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $77.84 / $151.44 / $513.84	Professional	TC	$77.84	$151.44	$513.84
United Facility/Professional Professional Modifier Low / Median / High Price $170.25 / $262.29 / $590.79	Professional		$170.25	$262.29	$590.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $59.13 / $82.11 / $124.80	Professional	26	$59.13	$82.11	$124.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $120.39 / $173.06 / $625.39	Professional	TC	$120.39	$173.06	$625.39